Healthcare Provider Details

I. General information

NPI: 1275607665
Provider Name (Legal Business Name): VIOLA ELIZABETH NUNGARY M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 W WASHINGTON ST STE A
CARSON CITY NV
89703-3837
US

IV. Provider business mailing address

PO BOX 13279
SOUTH LAKE TAHOE CA
96151-3279
US

V. Phone/Fax

Practice location:
  • Phone: 530-542-0800
  • Fax:
Mailing address:
  • Phone: 530-542-0800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC31975
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT0671
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: